Understanding preferences for type 2 diabetes mellitus self-management support through a patient-centered approach: a 2-phase mixed-methods study

Abstract

Background: Patients with type 2 diabetes mellitus (T2DM) who participate in diabetes management programs have been shown to have better glycemic control and slower disease progression, although program participation remains low. In the USA, increasing participation in diabetes management support programs may also directly impact provider reimbursement, as payments are increasingly based on patient-centered measures. However, little is known about factors that may enhance patient participation. This study aimed at further understanding what is important in diabetes management support from the patients' perspective and at assessing the utilization of various types of diabetes-management programs.

Methods: A two-phase mixed-methods study was conducted of adult US members of PatientsLikeMe®, an online research network of patients. Phase 1 comprised qualitative interviews with 10 individuals to inform the online survey's contents, aided by literature review. During phase 2, this online survey was completed by 294 participants who reported on their diabetes goals and preferences for T2DM self-management support programs.

Results: The majority of the respondents were not participating in any program (65 %), but most had goals of improving diet (77 %), weight loss (71 %), and achieving stable blood glucose levels (71 %). Among those currently participating in programs, clinic, hospital-based, or other health-care professional programs were the most commonly used (51 %). The most preferred type of support was diet/weight-loss support (62 %), while doctors or nurses (61 %) and dietitians (55 %) were the most preferred sources of diabetes support.

Conclusions: The low participation in diabetes self-management programs revealed in this study underscores the need for strategies to improve patient engagement. The results revealed support types and formats that patients with T2DM prefer and need. These findings may help improve patient engagement by guiding the future design of more effective diabetes management support programs.

Keywords: Diabetes management support; Patient participation; Type 2 diabetes mellitus.

Fig. 1

Flow diagram of study participants. ^aParticipation rate = 37.1 %; ^bCompletion rate = 30.4 %

Fig. 2

Program utilization among survey respondents currently participating in a form of support^a (n = 101). HCP, health-care professional. ^aRespondents could have participated in more than one program

Fig. 3

Overall satisfaction with health-care team in the past year by current program participation^a. ^a Z = −2.28; P = 0.0022

Fig. 4

Types of support preferred by survey respondents. HCP, health-care professional

Fig. 5

Sources of support preferred by survey respondents

Fig. 6

Format of support most preferred by respondents^a (n = 294). ^aParticipants could select more than one form of support